2010 MALAWI MILLENNIUM DEVELOPMENT GOALS REPORT

Transcription

1 Government of Malawi 2010 MALAWI MILLENNIUM DEVELOPMENT GOALS REPORT Ministry of Development Planning and Cooperation P.O. Box Lilongwe 3 Malawi i

2 Ngwazi Prof. Bingu wa Mutharika HIS EXCELLENCY THE STATE PRESIDENT OF THE REPUBLIC OF MALAWI My Government is committed to accelerate the attainment of the millennium development goals by implementing a robust development strategy ii

3 Foreword The Government of Malawi is undertaking unequivocal efforts in reducing poverty and improving the welfare of its people. This dedication is manifested through the signing of the Millennium Declaration adopted at the United Nations (UN) General Assembly in New York in September, This initiative is aimed at reducing abject poverty affecting more than one sixth of the world s population. The implementation of the Millennium Development Goals (MDGs) in Malawi is being done through the medium term development strategy known as the Malawi Growth and Development Strategy (MGDS). The strategy, which runs from 2006 to 2011, aims at creating wealth through sustainable economic growth as a means of reducing poverty. Initially the strategy focused on six priority areas, which have been revised to nine since Government believes that the successful implementation of the key priority areas will have positive implications on the achievement of the MDGs and other pertinent development indicators. The 2010 Millennium Development Goals report provides an update with respect to achievements Malawi has made on the attainment of the MDGs. The assessment has clearly shown that the country is on track to attaining MDG targets by the year Stakeholders engaged in development activities in various sectors of the economy agriculture and food security, health, education, environment, gender will be pleased to see the impacts of their efforts through the quantitative assessments made in this report. This report has also highlighted challenges that are being faced in the course of implementing relevant development policies to attain MDG targets and possible solutions to resolve them. It is my hope that government and all its stakeholders are going to put their effort together to overcome these challenges to ensure that Malawi attains the MDG targets by Abbie Marambika Shawa, MP MINISTER OF DEVELOPMENT PLANNING AND COOPERATION iii

4 Acknowledgments This report was compiled through the work of numerous individuals too many to mention. They played different roles at different stages of the report. Many stakeholders were involved in the collection and compilation of qualitative and quantitative data. The Ministry would like to thank all individuals for their dedication and hard work. The Ministry would also like to thank UNDP and its MDG country team for the financial and administrative support rendered towards the production of the report. iv

5 Table of Contents Acknowledgments... iv List of Figures... vi List of Acronyms... vii Status at a Glance... ix Executive Summary... xi Introduction Goal 1: Eradicating Extreme Poverty Goal 2: Achieve Universal Primary Education Goal 3: Promote Gender Equality and Empower Women Goal 4: Reduce Child Mortality Goal 5: Improve Maternal Health Goal 6: Combat HIV and AIDS, Malaria and other diseases Goal 7: Ensure Environmental Sustainability Goal 8: Develop Global Partnership for Development Bibliography v

6 List of Figures Figure 1: Poverty Head Count Figure 2: Poverty Gap Ratio Figure 3: Poorest Quintile Share in National Consumption Figure 4: Underweight Prevalence Figure 5: Proportion of Ultra-poor Figure 6: Net Enrolment Rate in Primary Education Figure 7: Proportion of Pupils Starting Grade 1 reaching Grade Figure 8: Literacy Rate of Year Olds Figure 9: Ratio of Girls to Boys in Primary Education Figure 10: Ratio of Girls to Boys in Secondary Education Figure 11: Ratio of Literate Women to Men years Old Figure 12: Share of Women in Wage Employment in Non- Agricultural Sector Figure 13: Proportion of Seats Held by Women in Parliament Figure 14: Under-Five Mortality Rate Figure 15: Infant Mortality Rate Figure 16: Proportion of 1 Year Old Children Immunized against Measles Figure 17: Maternal Mortality Ratio Figure 18: Proportion of Births Attended by Skilled Health Personnel Figure 19: HIV Prevalence Among year Old Pregnant Women in Malawi Figure 20: Ratio of Orphans to Non-orphans in Schools Figure 21: Death Rates Associated with Malaria Figure 22: Access to Malaria Treatment Figure 23: Proportion of Household with at least One ITN Figure 24: Death Rates Associated with Tuberculosis Figure 25: Proportion of TB Cases Cured Under DOTS Figure 26: Proportion of Land Area Covered by Forest Figure 27: Ratio of Area Protected to Maintain Biological Diversity to Surface Area Figure 28: Proportion of Population Using Solid Fuels Figure 29: Household with Sustainable Access to Improved Water Source Figure 30: Proportion of the Population with Access to Improved Sanitation Figure 31: Percentage of Slum Houses Figure 32: Net ODA as a Percentage of Real Gross Domestic Product Figure 33: Unemployment of Year Old Figure 34: Cell phone Subscribers Figure 35: Landline Subscribers Figure 36: Internet Subscribers vi

7 List of Acronyms AIDS ARV CBE CBO CDSS DAS DOTS EHP EU EPI FAO HESSEA HIPC HIV HSA ICT IHS IMS IRI IT ITN IVL IMCI LA MACOHA MASEDA MARDEF MAREP MIE MDG MDHS MDRI MGDS MICS MPVA MTEF NER NESP PHC ODA OVOP PCAR PSIP RBM Acquired Immune Deficiency Syndrome Anti-Retroviral drugs Complementary Basic Education Community Based Organisation Community Day Secondary Schools Development Assistance Strategy Direct Observable Treatment Short Essential Health Package European Union Expanded Programme for Immunization Food and Agricultural Organization Household Expenditure and Small Scale Economic Activities Highly Indebted Poor Countries Human Immuno-deficiency Virus Health Surveillance Assistant Information Communication Technology Integrated Household Survey Information Management System Interactive Radio Instruction Information Technology Insecticide Treated Net Interactive Video Learning Integrated Management of Child Illness Artemether Lumefantrine Malawi Council for the Handicapped Malawi Social Economic Database Malawi Rural Development Fund Malawi Rural Electrification Programme Malawi Institute of Education Millennium Development Goal Malawi Demographic and Health Survey Multilateral Debt Relief Initiative Malawi Growth and Development Strategy Multiple Indicator Cluster Survey Malawi Poverty Vulnerability Assessment Medium Term Expenditure Framework Net Enrollment Rate National Education Sector Plan Population and Housing Census Overseas Development Assistance One Village One Product Primary Curriculum Assessment Review Public Sector Investment Programme Roll Back Malaria Programme vii

8 SADC STDs SWAp TB UN UNICEF UNDP UNFPA UNEP UPE WMS Southern Africa Development Community Sexually Transmitted Diseases Sector Wide Approach Tuberculosis United Nations United Nation Children s Fund United Nations Development Programme United Nations Fund for Population United Nations Environment Programme Universal Primary Education Welfare Monitoring Survey viii

9 Status at a Glance Malawi's Progress Towards Achieving the Millennium Development Goals GOAL/TARGET Eradicate Extreme Poverty and Hunger Achieve Universal Primary Education Promote Gender Equality and Empower Women Reduce Child Mortality Improve Maternal Health Combat HIV and AIDS, Malaria and other diseases Ensure Environmental Sustainability Indicator Current Status 2015 Target Proportion of population living below US$1.00 per person per day 39 % 27% Poverty Gap Ratio % Poorest Quintile Share in National Consumption 10.1 % 20% Prevalence of Underweight Children 17 % 14% Proportion of population below minimum level of dietary energy consumption 15% 11.8% Net Enrolment in Primary 83 % 100% Proportion of Pupils Starting Grade1 Reaching Grade % 100% Literacy Rate (15-24yrs) 84 % 100% Ratio of Girls to Boys in Primary Education Ratio of Girls to Boys in Secondary Education Ratio of Literate Women to Men Years Old Share of Women in Wage Employment in non- Agriculture Sector 15 % 50% Proportion of Seats Held by Women in Parliament 22 % 50% Under-five mortality rate 122 per 78 per 1,000 1,000 Infant Mortality rate per per 1,000 1,000 Proportion of 1 year children immunized against measles 84 % 100 % Maternal mortality ratio 807 per 100, per 100,000 Proportion of births attended to by skilled health personnel 75 % 100% HIV prevalence among year old pregnant women 12% 0% Ratio of orphans to non-orphans in school Deaths rates associated with Malaria 3% - Access to Malaria Treatment 22% - Proportion of Household with at least one ITN 60% - Death rates associated with Tuberculosis 8% - Proportion of TB Cases under DOTS 86% - Proportion of land covered by forest 36.2% 50% Proportion of area protected to maintain biological diversity 0.16% 0.18% Proportion of population using solid fuel 98.% 0% Proportion of population with sustainable access to an improved water source 81% 74% Feasibility of achieving the Goal Likely to be met Unlikely to be met Unlikely to be met Likely to be met Unlikely to be met Likely to be met Likely to be met ix

10 Develop Global Partnership for Development Proportion of population with access to improved sanitation 93% 86.2% Slum population as percentage of urban population 67.7% - Net ODA as a percentage of Real Gross Domestic Product 22% - Unemployment of year old (urban) 4% - Telephone lines subscribers per 100 population 2.3% - Cellular subscribers per 100 population 21% - Internet users per 1,000 population 10.5% - Likely to be met Note: - means no target set for the indicator x

11 Executive Summary Malawi remains committed to achieving the millennium development goals (MDGs) by 2015 through the implementation of her own national development strategy, called the Malawi Growth and Development Strategy (MGDS). The Strategy covers the period 2006 to 2011, and a successor MGDS will be designed before the current one expires. This 2010 assessment on progress achieved in attaining the eight MDGs shows positive results. Five of the goals are likely to be achieved, and the other three are in doubt not for lack of effort to achieve them but due to the fact that the country had a much lower starting base compared to other countries. The five MDG targets that are likely to be achieved are on eradicating extreme poverty, reducing infant mortality, combating HIV and AIDS, malaria and other diseases, ensuring environmental sustainability, and developing global partnership for development. The three that are in doubt are on achieving universal primary education, reducing gender inequality and maternal mortality. Under eradicating extreme poverty, the measure of poverty head count has declined by 11 percent from 2005 to 2009 and on the poverty gap ratio by 0.8 percent from the year 2000 to While the country is making progress in reducing poverty levels, the challenge still remains in reducing income inequality. Reducing child mortality is likely to be attained, and possibly surpassed. Currently, under-five mortality rate is at 122 deaths per 1000 live births and infant mortality at 69 deaths per 1000 live births in If the provision of health services continues at the rate they are being delivered, or improved beyond that then the country is on course to surpass the MDG targets. Halting HIV and AIDS, malaria, and other diseases is also likely to be attained. Estimates of the national HIV prevalence rate among 15 to 24 year old pregnant women has been reduced by half from about 24 percent to 12 percent between 1998 to If this trend is sustained, the national HIV prevalence rate will be at 6 percent in As for other diseases like TB, the trend shows that Malawi is likely to reverse its incidence as evidenced by declining death rates associated with this disease. The goal of ensuring environmental sustainability is also on course for attainment. There are six indicators for this goal, and half of them show that things are on track while the others show otherwise. The land area covered by forest has declined steadily over the years, from 41.4 percent in 1990 to 36.2 percent in If this trend continues, Malawi s land area covered by forest will be less than 33 percent by However, the number of households with sustainable access to improved water sources has been increasing, such that if the current levels are maintained, this may surpass the MDG target by about 20 percent. xi

12 The goal of developing global partnership for development is also likely to be attained. The indicators for this include the rate of youth unemployment and telephone penetration. Data shows that youth unemployment has declined from 9 percent in 2006 to 4 percent in The trend for cellular phone subscribers per 100 people indicates that there has been an increase in subscribers from around 2 percent in 2004 to about 21 percent in This rapid increase can be attributed to low-cost cell phone handsets and an increased demand for faster communication. The projection shows that by 2015, about 34 percent of the population will be subscribed. For landline subscribers, there has been a low increase in the number of subscribers for fixed lines from about 0.6 percent in 2004 to about 2 percent in Achievement of universal primary education is unlikely to be attained. Primary school education is free, but the net enrolment rate is not yet 100 percent. It stands at 83 percent in 2009, and the proportion of pupils starting grade one who reach grade five without repeating a grade has declined from 86 percent in 2006 to 76 percent in The youth literacy rate is currently at about 84 percent. According to linear projections, the attainment of this MDG will depend on capacity to scale up efforts beyond the historical levels. The improvement in maternal health is one of the three goals that would be difficult to attain. The country has been able to reduce maternal deaths from 984 per 100,000 live births in 2004 to 807 per 100,000 live births in 2006, but the desired target is almost six times below the desired rate. The country is also off track in reaching the target of births being attended by skilled birth personnel. The proportion of births attended by skilled personnel has increased from 57 percent in 2004 to 75 percent in Despite this improvement, the projection shows that by 2015 deliveries conducted by skilled attendants will have increased to 82 percent, falling short of the MDG target. The last of the three MDG goals that is unlikely to be attained is the promotion of gender equality and women empowerment. Gender inequalities exist in accessing productive resources, development opportunities and decision making. Currently, the ratio of girls to boys in primary school is 1.03 and with this progress, a ratio of 1:1 would be surpassed. However the ratio of girls to boys in secondary school is meanwhile at This trend therefore shows that gender parity, in aggregate terms, may be achieved at primary education level but not at secondary level, which in turn affects the ratio of girls to boys at the tertiary level. xii

13 Introduction The UN General Assembly for Heads of State and Governments adopted long term development agenda for low income countries in partnership with high income countries. This long term development agenda is prescribed in the 2000 Millennium Declaration, to which 189 member countries, including Malawi are signatories. The agenda has eight goals, which are aimed at creating an enabling environment that will facilitate socioeconomic development and the promotion of human rights in member countries. The eight millennium development goals (MDGs) are: 1) Eradicate extreme poverty and hunger, 2) Achieve universal primary education, 3) Promote gender equality and empowerment of women, 4) Reduce child mortality, 5) Improve maternal health, 6) Combat HIV/AIDS, malaria and other diseases, 7) Ensure environmental sustainability, and, 8) Develop a global partnership for development. The implementation of MDGs is done through medium term strategies which are then translated into annual budgets. The first three year strategy was the Malawi Poverty Reduction Strategy (MPRS) which was implemented from 2000 to A review of the MPRS in 2005 showed that much as the strategy emphasized on poverty reduction, it did not put much emphasis on economic sectors which are important for sustainable poverty reduction. It became apparent therefore that if Government was to make reasonable progress towards attainment of the MDGs, it had to redesign its development strategy. Lessons from MPRS implementation informed the formulation of the Malawi Growth and Development Strategy (MGDS). The MGDS, which is the second generation MPRSP provides an improved framework for implementing the MDGs. The strategy, which is designed to run from 2006 to 2011, has put emphasis on wealth creation and sustainable economic growth as a means to poverty reduction and human development. In addition, in allocating financial resources, government uses Medium Term Expenditure Framework (MTEF) and the Public Sector Investment Programme (PSIP) to ensure the smooth implementation of the MGDS. Government has set up an implementation, monitoring and evaluation framework to provide regular feedback on MDGs and MGDS. As in the past, a significant proportion of financing for MGDS will come from development partners. A central norm of the Paris Declaration (PD) on aid effectiveness is that government owned national strategies should provide the road map for development that development partners should seek to align their support to these strategies in the most effective and efficient ways possible. In view of this, government has finalised the Development Assistance Strategy, which seeks to increase alignment of Malawi s development partners to the MGDS using the most practical and efficient balance of aid modalities. The DAS sets out the policy and strategies for increasing 13

14 efficiency and effectiveness in the mobilisation and utilisation of such aid in achieving the development results set out in the MGDS. The DAS seeks to achieve its objective through the operationalisation of the five key principles from the 2005 Paris Declaration on aid effectiveness, namely: national ownership of the national agenda; alignment of development partners to the national development strategy and government systems; harmonisation of development partner s systems and activities; managing resources and decision making for results and; mutual accountability for development results. Government recognises that improved coordination of financial support from the various development partners will improve the implementation and the achievement of MGDS outcomes and ultimately resulting in the attainment of the MDGs. 14

15 Goal 1: Eradicating Extreme Poverty Extreme poverty is defined as the inability to meet basic minimum food requirements based on monthly cost of a food basket. Eradicating extreme poverty is the first of the eight MDGs and two main targets were set to achieve the goal by the year The first target is to halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day. To monitor progress made towards achieving the target, three indicators are used and these are: proportion of population below national poverty line; poverty gap ratio; and share of the poorest quintile in national consumption. The second target is to halve, between 1990 and 2015, the proportion of people who suffer from hunger. This has two indicators which are; prevalence of underweight children under five years of age, and the proportion of population below the minimum level of dietary energy consumption. Target 1: Halve between 1990 and 2015 the Proportion of People whose Income is less than one Dollar per day Indicator 1: Proportion of people below the poverty line 1 (poverty head count) Figure 1: Poverty Head Count Source: HESSEA 1991, IHS 1998, 2000, and WMS 2005, 2006, 2007, 2008 Figure 1 shows changes in poverty rates between 1990 and The figure shows that poverty has declined from 54 percent in 1990 to about 39 percent in However, with respect to place of residence, figures show that poverty in rural areas has been declining steadily since 2005 even though there are still more poor people in rural than urban areas. 1 Proportion of people living on less than one US dollar a day 15

16 This decline in poverty could be attributed to increased agriculture productivity realized through farm input subsidy programme among other government interventions. On the other hand, urban poverty declined from 24 percent in 2005 to 11 percent in 2007 but slightly increased to 13 percent in This could be due to urban migration amongst others. Nevertheless, at this rate of change, poverty is projected to reduce to 27 percent by This implies that the country is on track to achieve the MDG target. Indicator 2: Incidence of depth of poverty as measured by the poverty gap The poverty gap ratio is the average distance separating the poor from the poverty line expressed as a percentage of the poverty line. In addition to counting the number of poor people, the poverty gap also indicates the extent of poverty amongst the poor. Figure 2: Poverty Gap Ratio Percent Current Path Linearly Projected Value MDG Target Source: HESSEA 1991 and IHS 1998, 2000, 2005 Figure 2 show that poverty gap ratio has increased from 16 percent in 1990 to about 19 percent in If this rate of change continues, the poverty gap ratio will have declined to around 16 percent by the year This is an indication that Malawi is unlikely to reduce the poverty gap ratio by half by the year

17 Indicator 3: Share of poorest quintile in national consumption. This indicator measures the share of the poorest quintile in national consumption. The target under this indicator target is to double the share of the poorest quintile in national consumption. Figure 3: Poorest Quintile Share in National Consumption Percent Current Path Linearly Projected Value MDG Target Source: IHS 1998 and 2005 Figure 3 shows that there has been no improvement on the share of the poorest quintile in national consumption between 1998 and 2005 as revealed by Integrated Household Surveys conducted in 1998 and Both surveys show that the poorest 20 percent of the population controlled only around 10 percent of the national consumption implying that inequality is not decreasing. At this rate, the MDG target will not be achieved by Target 2: Halve, between 1990 and 2015, the Proportion of People who Suffer from Hunger The two main indicators for monitoring hunger are the prevalence of underweight children under five years of age and the proportion of the population living below the minimum level of dietary energy consumption. Indicator 1: Prevalence of underweight children (under five years of age) Malnutrition remains a serious challenge globally and the single biggest contributor to child mortality. Children s nutritional status is a reflection of their overall health and development. The nutritional wellbeing of young children is therefore a sign of the household, community and national investment in family health. Prevalence of underweight children is taken as a proxy indicator of proportion of population that is undernourished. Food intake for undernourished population is always below minimum requirements and insufficient to meet dietary energy. 17

18 Figure 4: Underweight Prevalence Source: MDHS 1992, 2000, 2004 and WMS 2005, 2006, 2007, 2008, 2009 Figure 4 shows that there has been a major stride in curbing the problem of prevalence of underweight in children under-five years of age. Underweight prevalence has declined from about 25 percent in 2000 to 14 percent in However, underweight prevalence has slightly increased from 14 percent to 17 percent between 2007 to Underweight prevalence in rural and urban areas is also showing similar trends despite improvement in the country s food situation since This could be as a result of inadequate knowledge in food processing and utilization leading to hunger and malnutrition. Nevertheless, it is projected that by 2015, Malawi is likely to meet this target. Indicator 2: Proportion of population below minimum level of dietary energy consumption. The proportion of population below the minimum level of dietary energy requirement is estimated by defining a food poverty line. All persons below this line are deemed as ultra-poor. Proportion of ultra-poor in the population is used as a proxy indicator for the proportion of population below minimum level of dietary energy consumption. 18

19 Figure 5: Proportion of Ultra-poor Source: IHS 1998, 2005 and WMS 2005, 2006, 2007, 2008 Figure 5 shows that the ultra poor population has decreased from about 24 percent in 1998 to 15 percent in The ultra poor population in rural and urban areas has steadily been declining since 2005 even though there is still higher proportion of ultra poor households in the rural than urban areas. At this rate, the projected proportion of persons deemed ultra poor will be about 10 percent by Malawi is therefore on track to reduce by half the proportion of population below the minimum level of dietary Projections have shown that by 2015, Malawi will register proportion of 7.5 percent Ultra poor. Challenges There are several challenges that the country is facing with respect to eradicating extreme poverty and hunger, some of which include the following: high illiteracy rates that limit the adoption of new agricultural technologies; inadequate food storage, processing and utilization knowledge that result in food wastage; critical shortage of capacity and skills in many institutions that are involved in the delivery of development programmes; inadequate knowledge and skills on household dietary diversification, and offfarm economic empowerment to increase access to high nutritive value foods for varied and nutritious diet; 19

20 inadequate marketing infrastructure for rural communities, which discourages poor farmers and communities from growing cash crops and engaging in meaningful economic empowerment activities; and high disease burden such as HIV and AIDS, TB and malaria which affects the economically productive age group. Policy Framework and Strategies In an effort to reduce extreme poverty and hunger the government is implementing a number of strategies, which include the following: initiation of a number of agriculture programmes such as promotion of cash crops, agriculture input subsidy, green belt initiative to improve food security of smallholder farmers; construction of multipurpose dams to promote irrigation and provision of water supply; establishment of the MK5 billion Malawi Rural Development Fund (MARDEF) loans to enhance income generating capacity of the poor households; establishment of One Village One Product (OVOP) Scheme to encourage people to get into value adding processes; establishment of the MK 3 billion Youth Enterprise Development Fund which is providing financial resources to the youth for the establishment of businesses; rehabilitation of abandoned irrigation schemes for smallholder agriculture production for maize, rice and vegetables; and, promotion of advocacy for proper storage of food crops through metal storage facilities. 20

21 Goal 2: Achieve Universal Primary Education Universal access to basic education and the achievement of primary education by the World s children is one of the most important goals of the MDGs. Education is a vital prerequisite for combating poverty, empowering women and protecting children from hazardous and exploitative labour and sexual exploitation among others. It is for this reason that the Government of Malawi has included education as one of the nine priority areas in the national development strategy. The primary focus is to improve access and quality of education. To this extent government has over the years been increasing budgetary allocation towards education sector. Malawi government recognizes that human capital development is key in sustaining social and economic development. Target 3: Ensure that by 2015, all Boys and Girls should be able to complete a Full Course of Primary Schooling Indicator 1: Net Enrolment Rate (NER) in primary education Net enrolment rate in primary education is defined as the extent to which the school going age (6-13) is enrolled in schools. This is a percentage calculated by dividing the number of school going age children enrolled in schools with the total number of the same age in the population. Figure 6: Net Enrolment Rate in Primary Education Source: MDHS 1992, 2000, 2004 and WMS 2006, 2007, 2008,

22 There has been an increase in the primary school net enrollment since 2006 from 73 percent to 83 percent in Urban areas have a higher net primary school enrolment rate than rural areas even though the gap is narrowing since the year The differences in net enrolment between the rural and urban areas might be attributed to easy access to education facilities in urban areas as compared to rural areas. If current investments and provisions to education sector are maintained it is projected that net enrolment rate will reach about 92 percent, falling short of the MDG target of 100 percent by 8 percent. Indicator 2: Proportion of pupils starting Grade 1 who reach Grade 5 Figure 7: Proportion of Pupils Starting Grade 1 reaching Grade 5 Source: MDHS 1992, 2000, 2004, MICS 2006 and EMIS 2008 This indicator measures the extent of drop out in primary education. Figure 7 shows that the proportion of pupils starting Grade 1 who reach Grade 5 without repeating a grade has increased from 69 percent in 2000 to about 76 percent in Proportion of pupils starting Grade 1 who reach Grade 5 is projected to reach about 75 percent in 2015, which is below the MDG target of 100 percent. 22

23 Indicator 3: Literacy Rate of year-olds Figure 8: Literacy Rate of Year Olds Source: MDHS 2000, 2004 and WMS 2005, 2006, 2007, 2008 and 2009 Figure 8 shows that youth literacy has increased from 68.1 percent in 2000 to about 84 percent in Literacy rate by sex indicates that there is a higher percentage of literate males compared to females. However, the percentage of literate females has increased significantly between 2006 and 2009as compared to males. This could be as a result of increased female participation in adult literacy programmes. At this rate of improvement, youth literacy would reach about 95 percent by 2015 slightly below MDG target. Challenges Despite the positive developments in the education sector, it still faces a number of challenges which continue to undermine full realization of quality education service delivery. These include: shortage of qualified primary school teachers; inadequate physical infrastructure; poor retention of girls mainly from standard five to eight; high disease burden due to HIV and AIDS consequently leading to absenteeism especially among girls who take care of the sick; and poor participation of school committees and their communities in school management. Poverty levels are high in rural areas. 23

24 Policy Framework and Strategies Government of Malawi initiated universal primary education (UPE) in 1994/ 95 with the main objective of increasing access to quality primary education. Government removed primary school fees and abolished school uniform as a requirement to attend classes to ensure that many boys and girls are able to enroll in school. In order to mitigate the emerging challenges on UPE, the education sector is engaged in policy re-definition. The National Education Sector Plan (NESP, 2008) outlines some of the redefined guiding principles and strategies to tackle issues of access at primary level as follows: reduction of pupil-teacher ratio, transfer of teachers from community day secondary schools (CDSSs) to primary schools; regular replenishment of textbooks for pupils and roll out of the primary curriculum assessment reform (PCAR) to all classes by 2009/10; construction of 50 primary schools and 1,000 teachers houses annually through Pooled financing; construction of 1,500 classrooms annually through the pooled funding mechanism (Joint Financing Arrangement); Upgrading of junior primary schools to full primary schools; provision of grants to girls in selected areas especially at senior primary level and scaling up school feeding programmes (School Meals) to increase enrollment and retention; Scaling up the initiative of Take Home Rations to selected pupils in selected primary schools and expansion of existing Teacher Training Colleges and construction of additional colleges in order to improve on the quality and number of qualified teachers in primary schools. 24

25 Goal 3: Promote Gender Equality and Empower Women It has widely been accepted that gender inequality exists in Malawi and this status quo affects women more than their male counterparts. The Malawi Growth and Development Strategy (MGDS) recognises that there is high correlation between poverty, social vulnerability and gender inequality. This is the reason why even though women constitute 52 percent of the population in Malawi, they are in most cases marginalized in social and economic spheres and, therefore, unable to effectively contribute to social, economic and political development. Strongly related to the above scenario is the high illiteracy level among women (56 percent as compared to 28 percent for men). This is fuelled by the high girl drop rates from the formal schooling system, a trend that eventually feeds back into a vicious cycle where once again one will expect to have very few women in formal employment. Target 4: Eliminate Gender Disparity in Primary and Secondary Education, preferably by 2005, and in all Levels of Education no later than Indicator 1: Ratio of girls to boys in primary education. Figure 9: Ratio of Girls to Boys in Primary Education Source: MDHS 1992, 2000, 2004, EMIS 2006, 2007, 2008, 2009 Figure 9 shows that the ratio of girls to boys in primary school has increased from 0.91 in 2000 to 1.03 in This trend shows that the gender disparity gap at primary school level with respect to enrolment has narrowed considerably. The narrowing of the gender gap in primary school enrollment rate could be a result of government policy shift towards girl child education. With the abolition of school fees and school uniform as a 25

26 requirement to attend classes, many households can afford to send their girl children to school. Sanitation issues have been adequately addressed in most public primary schools and this has created a conducive environment for girls in the schools. The projected figure shows that Malawi is on track and has met the MDG target in Indicator 2: Ratio of girls to boys in secondary education. Figure 10: Ratio of Girls to Boys in Secondary Education Source: MDHS 1992, 2000, 2004, EMIS 2008, 2009 The ratio of girls to boys in secondary schools has increased from 0.60 in 2000 to 0.79 in 2009 as shown in Figure 10. The projection shows that a ratio of 1:1 will not be attained by This trend seems to reveal that the education system loses a significant number of girls with progressive levels of education. The reason for this is that many girls drop out of school or repeat as they progress through the grades in primary education, thereby resulting in low girl intake at secondary school level and consequently at tertiary level. Some of the factors that force girls out of school could be: early marriages and pregnancies, family and cultural responsibilities. Girls are more likely expected to assume the roles of providing care and support for relatives that are aged or sick than boys. This implies that the elimination of gender disparities remains a challenge at secondary level. This might also be the case at tertiary level. Hence the need to come up with strategies to ensure that the targeted interventions have an impact at all levels of education. 26

27 Indicator 3: Ratio of Literate Women to Men year olds Figure 11: Ratio of Literate Women to Men years Old Source: MDHS1992, 2000 and 2004 and WMS 2005, 2006, 2007, 2008 Figure 11 shows that the ratio of literate females to males aged years has increased from 0.82 in 2000 to 0.94 in Results also indicate a higher ratio of literate women to men in urban areas than rural areas. Even though there are more literate women to men in urban than rural areas, the ratio of literate women to men in rural areas has increased since This could be as a result of government s commitment to reduce illiteracy among the adult population with a special emphasis on women. Assuming the same rate of improvement continues, the ratio of literate females to males would reach equality in Indicator 4: Share of Women in Wage Employment in the Non- Agriculture Sector The indicator on share of women in wage employment in the non agriculture sector is a measure of employment opportunities. Given equal opportunities it is expected that there would be equal proportions of men and women in formal employment. However this is not the case. More women participate in the agriculture sector than in the formal wage employment especially in jobs that require professional qualifications. Some of the reasons for the lower participation in wage employment among women could be due to literacy levels, gender disparity and cultural values. 27

28 Figure 12: Share of Women in Wage Employment in Non- Agricultural Sector Current Path Linearly Projected Value MDG Target 50 Percent Source: IHS 1998 and 2005 Figure 12 shows that women s share in wage employment has increased from 13 percent in 2000 to 15 percent in This trend suggests that women occupy a very small share of wage employment in the non-agricultural sector. Hence, the target of having an equal proportion of men and women in wage employment by the year 2015 is unlikely to be met. Indicator 5: Proportion of seats held by women in National Parliaments The proportion of seats held by women in national Parliament has improved significantly over time. During the 1999 presidential and parliamentary elections, out of 193 elected members of parliament, only 18 members of parliament were women. In the 2004 presidential and parliamentary elections, 27 women were elected out of 193 and in the 2009 presidential and parliamentary elections, 43 out of 193 elected members of parliament are women. However, in absolute terms the number of women parliamentarians is still low when compared to men parliamentarians. 28

29 Figure 13: Proportion of Seats Held by Women in Parliament Current Path Linearly Projected Value MDG Target 50 Percent Source: Malawi National Assembly (2009) Figure 13 above shows that there has been an increase in the proportion of seats held by women in the national assembly. However, the number of male parliamentarians is still higher than women. Assuming the same rate of improvement continues, the share of women in parliament is projected to reach about 32 percent by This implies that a target of 50 percent share of women in the national assembly may not be achieved. Challenges These are some of the challenges faced in promoting gender equality and women empowerment: limited capacity in terms of human and material resources to facilitate adult literacy and continuing education; early marriages perpetuated by socioeconomic factors; socio cultural factors that make people believe that men should be leaders while women are followers; and, poor learning environment which affects girls in primary and secondary schools e.g. sanitary facilities, long distances to education facilities, extra burden from domestic chores especially for adolescent girls resulting into high dropout rate. Policy Framework and Strategies While recognizing important efforts that are being made in the area of gender equality and empowerment, there is still need to ensure that gender concerns are streamlined in all government policies and strategies. Government has therefore put in place a number of strategies in an effort to eliminate gender disparities. Some of the strategies include: construction and expansion of girls boarding facilities in secondary schools and teacher training institutions; 29

30 revision of the re-admission policy in 2006, which makes it friendly for students who withdraw on pregnancy grounds to go back and continue with their education; encourage girls to pursue education in fields that have traditionally been dominated by men; introducing equitable selection policy at secondary schools and higher education institutions for girls and boys to share 50 percent of places; increase budgetary allocation to national adult literacy programme to improve its quality and scope; similarly strategies will be designed to attract male participation in adult literacy classes; introduction of 50: 50 programme that focuses on increasing women participation in politics at all levels; and, taking affirmative action to increase number of women in decision making positions in the public and private sectors. 30

31 Goal 4: Reduce Child Mortality Government is committed to reducing child mortality. As a manifestation of such commitment, government has over the years intensified investment in essential health care services. Special focus has been put on human resources development and retention; procurement of essential basic equipment, drugs and other medical supplies; and providing infrastructure. There has also been improved collaboration between Ministry of Health, development partners and non-state actors through the implementation of the Health SWAp Programme of Work, Target 5: Reduce by Two Thirds the Mortality Rate among Children Under-five Indicator 1: Under-five mortality rate Figure 14: Under-Five Mortality Rate Source: MDHS 1992, 2000, 2004 and MICS 2006 Significant progress has been made in the provision of child health services. Figure 14 shows that under-five mortality has been declining steadily from 234 deaths per 1,000 live births in 1990 to 122 per 1,000 live births in Under-five mortality has been decreasing since in both urban and rural areas since If this trend continues, it is expected that by 2015, there will be 59 deaths of under-five children out of 1000 live births. This implies that the country is likely to reduce under-five mortality by more than two-thirds of the 1992 level. 31

32 Indicator 2: Infant mortality rate (IMR) Figure 15: Infant Mortality Rate Source: MDHS 1992, 2000, 2004 and MICS 2006 Figure 15 shows that the country has made remarkable progress in reducing the infant mortality. Infant mortality rate has been steadily declining from a high level of 134 deaths per 1,000 live births in 1992 to 69 per 1,000 live births in Similar trends are observed in rural and urban areas except for years between 2004 and 2006 where urban infant mortality rate has increased from 60 deaths per 1000 live births to 70 deaths per 1000 live births. This decline could be attributed to various interventions that the Government is implementing among them extended Programme of immunization deworming and distribution of insecticides treated mosquito nets are undertaken. It is projected that by 2015, IMR will reduce to 32 deaths per 1,000 live births hence surpassing the MDG target of 44 deaths per 1000 live births. Indicator 3: Proportion of 1-year old children immunized against measles. Figure 16: Proportion of 1 Year Old Children Immunized against Measles 32

33 Percent Current Path Linearly Projected Value MDG Target Source: MDHS 1992, 2000, 2004 and MICS 2006 Figure 16 shows that the proportion of 1 year old children immunized against measles decreased from 83 percent to about 79 percent between 2000 to However, the rate improved in 2006 to 84 percent largely due to the implementation of an integrated management of child illness approach. The projection shows that Malawi may attain the target by 2015, if the current efforts are maintained. Challenges Malawi still faces challenges in its efforts to reduce child mortality. Some of these challenges include; resource constraints to successfully provide the high impact essential health interventions; weak inter-sectoral collaboration has also constrained the health sector from dealing with other determinants of poor child health, such as water, sanitation and malnutrition; increased morbidity and mortality as a result of the HIV and AIDS pandemic also poses a challenge to the accelerated reduction of child mortality; and capacity constraints in training institutions due to lack of adequate teaching space, hostels and shortage of tutors thereby derailing the fight against high infant mortality. Policy Framework and Strategies: There are a number of initiatives that are being implemented in the health sector which include: integrated Management of Child Illnesses (IMCI) Approach and implementation of the Essential Health Package (EHP); introduction of Sector Wide Approach ( SWAp) which has focused on both the implementation of interventions as well as development and strengthening of related health systems; continuous and accelerated training of health workers such as Health Surveillance Assistants (HSA); 33

34 implementation of baby friendly initiative and child health days campaigns where de-worming, vitamin A vaccination, distribution of insecticides treated mosquito nets and promotion of improved sanitation are undertaken; implementation of targeted nutrition support through community based therapeutic care, positive deviants (P- Hath) initiatives and supplementary feeding at all levels. 34

35 Goal 5: Improve Maternal Health Malawi is among the countries with the highest maternal mortality rates in the world. The country, like many developing countries, experience complications of pregnancy and childbirth as a leading cause of deaths and disability among women of reproductive age. Hence there is need for more improvement on antenatal care; basic emergency obstetric care; and postnatal care, in order to achieve the targets with respect to maternal health. Progress under this goal is measured by two indicators, namely, proportion of births attended by skilled health personnel and maternal mortality ratio. The maternal health indicators for Malawi have generally remained poor over the last decade. Although maternal health performed poorly, there has been a general reduction in the maternal deaths over the past few years. Target 6: Reduce by Three Quarters the Maternal Mortality Ratio Indicator 1: Maternal Mortality Ratio Figure 17: Maternal Mortality Ratio Death per 100,000 Live Births Current Path Linearly Projected Value MDG Target Source: MDHS 1992, 2000, 2004, MICS 2006 As shown in Figure 17 above, maternal mortality rate increased alarmingly to 1,120 deaths per 100,000 live births in 2000 from a rate of 620 deaths per 100,000 live births in However, the maternal mortality ratio has decreased from 1,120 deaths per 100,000 live births in 2000 to 807 deaths per 100,000 live births in Despite this improvement, Malawi is unlikely to achieve the desired target as the projections show that by 2015, MMR will be 338 deaths per 100,000 live births which is way above the MDG target. 35

36 Indicator 2: Proportion of Births Attended by Skilled Health Personnel Figure 18: Proportion of Births Attended by Skilled Health Personnel Source: MDHS 1992, 2000, 2004 and WMS 2006, 2007, 2008, 2009 Figure 18 shows that there is a steady increase in the proportion of births attended by skilled health personnel from about 56 percent in 2000 to 75 percent in The figure also shows that there is a significant difference with respect to the proportion of births that are attended by skilled health personnel between rural and urban areas. From the figure, it can be seen that on average about 86 percent of women in urban areas are attended to by skilled health personnel when giving births compared an average 63 percent for rural women. It should be noted however, that the proportion of births that are attended by skilled health personnel in rural area has increased from the year 2008 to This increase could be as a result of government s policy of changing the role of Traditional Birth Attendants (TBAs) from delivering children to promoting institutional deliveries at community level. In addition, the introduction of service level agreement between public and private sectors may have significantly improved access to health care through elimination of user fees. At this rate, delivery by skilled attendants is expected to increase to about 82 percent by 2015 which falls below the MDG target. Challenges There are a number of challenges the health sector is currently facing which include; critical insufficiency of skilled human resources; poor access to essential health care services; 36